title: [Analysis of epidural hematoma formative reason and its preventive measure after anterior cervical operation].
abstract: OBJECTIVE
  To explore the risk factors,preventive measure of epidural hematoma after anterior cervical operation.
  
  
  METHODS
  From June 2005 and December 2012, 1,452 patients underwent anterior cervical operation in our hospital. Epidural hematoma occurred in 5 cases after operation and the incidence rate was 0.34%. There were 4 males and 1 female with an average age of 46.4 years (ranged, 33 to 55); 3 cases with cervical myelopathy, 1 case with cervical myelopathy and C5 vertebral angeioma, 1 case with ossification of cervical posterior longitudinal ligament. The occurred time,main clinical situation,duration of symptoms,operative management of epidural hematoma were analyzed.
  
  
  RESULTS
  Five patients with epidural hematoma occurred within 24 h; the average interval between onset of symptoms and surgery was 4 h (ranged, 2 to 7). Operative treatment was accomplished in 5 cases by exploration and hematoma evacuation. There was significant improvement in all patients after reoperation. Epidural hematoma occurred again in one patient at 5 h after hematoma evacuation, and reoperation were performed to treat it. All patients were followed up from 6 to18 months with an average of 13.8 months. No recurrence was found.
  
  
  CONCLUSIONS
  Intensive care in 24 h postoperatively is important because of epidural hematoma often occurs in this period,especialy in the period of 6-8 h postoperativey. Clinical findings and MRI can early diagnose epidural hematoma and help treatment. Once it is identified and surgical evacuation would be performed on time.
authors.affiliation: The Second Clinical College of Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053, Zhejiang, China. tigersong1029392929@gmail.com
authors.forename: Xiao-Hu
authors.initials: XH
authors.lastname: Song
authors.forename: Rong-Ming
authors.initials: RM
authors.lastname: Xu
authors.forename: Shao-Hua
authors.initials: SH
authors.lastname: Sun
authors.forename: Liu-Jun
authors.initials: LJ
authors.lastname: Zhao
authors.forename: Wei-hu
authors.initials: WH
authors.lastname: Ma
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000601:surgery*; D005260:Female; D046748:Hematoma, Epidural, Spinal / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*